Giant Abdominal Neuroblastoma in an Infant with Dilated Cardiomyopathy: An Intraoperative Challenge
Neuroblastomas are cancers that originate from neuroblasts and are found most commonly in infants. An association of neuroblastoma with dilated cardiomyopathy in an infant is rare and we report the successful perioperative management of a five-month-old baby with giant abdominal neuroblastoma and severe left ventricular systolic dysfunction. Our patient had a cardiac arrest during bone marrow aspiration and complexity of anaesthesia was determined by the large tumour mass compromising the respiration, increased intraabdominal pressure and cardiomyopathy with severe left ventricular dysfunction owing to effects of both chemotherapy and post cardio-respiratory arrest. Care of such patients is complicated by the fact that they have differing anaesthesia management goals, aiming at maintaining the patient’s hemodynamic variables of preload, heart rate, contractility and afterload, while also simultaneously maintaining respiratory parameters.
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